ATR Timeline

I made plans in early June to attend a Green Day concert at the LA Forum on August 25. Two weeks after I bought my tickets, I tore my Achilles. I figured there was no way I would get to go to the show. Cut to last night, I was on the floor of the Forum nodding my head to a great rock show. The crowd was pretty tame so I was never really in any danger of falling or getting knocked over. The worst part of it from a AT standpoint was standing for 3 straight hours. There was some swelling at the end of the night but no real pain and I am back to normal this am.

I got rid of the boot over the weekend. My first PT appt. went well. I have a few exercises to do and I’ll be going 2x a week for a while. Right now I just need to focus on heel to toe walking and strengthening. All the weeks of hopping around make this progress that much sweeter.

Third post-op apt. Doc took the final wedge out and told me to “assume the position” (on stomach with feet hanging off the end of the table). There is a small nub of scar tissue at the top of the incision which he said to leave alone. It looks almost like a pimple or bug bite. He said “your body will eat that”. He said 7-10 more days in the boot and then 2 shoes!!!! He checked ROM and said it is almost normal. I also mentioned that although I attempted to call in my scrip for PT a week ago, the soonest they could get me in is next week Monday. His response was, “That’s fine, good even - since more time to mend is better.” He then mentioned that there was a high degree of likelihood that my calf would never be the same size as the unaffected side. Honestly, I don’t care at this point as long as I can function normally and keep up with my 1 yr old. He had me “press the gas pedal” while I was on my stomach and seemed pleased with my effort.

Getting ready for bed last night (without the boot) I brifely lost my balance and put some weight on the wrong foot. It was brief and I certainly didn’t step down but I felt the pressure you would expect in the AT area. No pop or swelling and the discomfort (barely pain) subsided quickly. I am keeping my fingers crossed I didn’t do any damage. See the Doc on Monday so I’ll mention it to him. That was stupid on my part to be out of the boot in that situation. Fingers crossed it won’t be an issue. Everything feels status-quo today.

Update: 8/27 - Dr. said all is well. Removed the 2nd or three heel wedges in the boot and gave me a scrip for PT (gentle ROM/PRE/Moderately). He said I can get past neutral and that I could drive if I wanted. I am going hold off for now. Best news is the wound is closed and I can go swimming with my daughter for the first time (she just turned 1 yr old). I am excited about that!!!

1) there is no way I should even consider platlet rich injection therapy b/c it is expensive, there is no research on post op patients to support the therapy’s viability and most importantly he said the down side of introducing a foreign body (the needle) into the surgery site is that you could retard healing (i.e. infection). Sounds reasonable to me. I am dropping it.
2) No PT or swimming until after the next appt. (in 10 days).
3) he removed the first of the three wedges and walking FWB w/o crutches is easier.

He was pleased with the progress. He said the foot was close to 90 degrees which I gather is a good thing?

I am scheduled to get one of the three heel wedges out during what will be the second post op appointment.
Currently, my list of questions is as follows:
1) When can I start PT?
2) When can I swim in the pool?
3) Thoughts on platlet rich injection therapy post-op.

Anything else I should be taking up with my guy while I have his undivided attention for 5 minutes?

Update: I’ve been “walking” without crutches on the boot for the better part of the day. The pace is slow but I am getting from point a to point b. I noticed soreness at the top of the calf. Not bad soreness with the tendon but the kind of soreness you get when you work a muscle out that’s been dormant for a while. Gotta love that. Downside of this new mobility is that my good foot, back and rt knee are all a little achy from the off kilter (3 heel wedges) stride. Progress!

Much like my recovery from a rt ATR I am starting out with this blog slow and tentative. I tore my AT on fathers day during a game of pickup bball. It was during the 3rd game of the day. I came down from a shot (I’m told I missed) and landed with my rt foot behind me. I felt the telltale crack on the back of the ankle and looked for the culprit. I knew what it was right away from the lifeless limp state of my foot. 2 days later I was on the operating table and now 2 weeks post surgery I am hobbling around in a boot trying to “walk” FWB per the doc’s instructions. I say “walk” because what I am doing bears little resemblance to walking. In any event things are going fine I suppose. I get my work done just fine since I have a desk job. I’ve told the story of my injury approximately 30 millions times. Most people are surprised to hear how long it takes to recover from an ATR. I find that surprising but I think I am projecting my exposure to similar injuries in the sports world with NBA and NFL players. This one is a season ender folks. God bless my loving wife, she is the real victim in all this. She’s been run ragged between our 1 yr old and her 33 yr old.

Right now my short term goal is to be able to attend a football game (my beloved Michigan Wolverines) 10+ weeks out from surgery. I’ve heard conflicting reports from “you’ll be walking with a limp and a cane” to “don’t even try it since you will almost certainly re-injure it”. I’m going to play it by ear for now but I am encouraged by how good I feel right now (no pain and making progress with the boot). Hopefully I’ll keep it up. My second love is fishing (I live in LA so my yearly trip back home to Michigan is usually my only chance to go) and I am a little more worried about my chances at making that trip. The chance for a slip and fall on the uneven ground just seems too great. Again, day by day - inch by inch. One thing is fore sure, I am done with basketball. I’ll play horse with my daughter but that’s about it.

I see the doc next week which will be 3w 1d from surgery. My first post op was taking the cast off and being fitted with the boot (w/ 3 wedges). He tells me I will go back approx. every 10 days to remove a wedge and then go 10 more days with just the boot before switching to shoes. That is a scary proposition if ever there was one. The Doc seems to be taking an aggressive protocol which is fine with me (33 yrs old - good health). I previously had an ACL tear on the same leg (14 yrs ago) so I know about long term recoveries. The amount of atrophy in my calf over the past 3 weeks is stunning. I can’t imagine what it must be like for people who go the entire 6 weeks in a cast. I hope I never find out first hand. From reading everyone’s accounts and my own experience I know to speak up if something seems wrong and I certainly will take the cautious route when given the choice. My biggest gripe right now is that my doc is a Buckeye but we can’t all be perfect I suppose.

Fingers crossed and I will check back in with more news after my next appt.

Congratulations, you just posted something nobody really cares about to a nearly one year old thread. Who really cares if some over-paid professional got beaned? Just one of the risks they take for all that money.

Great blog and I hate to interupt but did you guys hear about David Huff? He threw a pitch to A-rod and it was hit back and knocked him out. Check out espn for the story. Again sorry to interupt just wanted to let everybody know.

Mike
My guy was definitely on board, in fact he did it. I have heard of it being done at the time of surgery but that was not how we approached it.
He drew a vial of blood and put it in a centrefuge(sp) for a while then he reinjected it using a sonogram for guidance. The whole procedure took about 40 min. I hade none of the residual pain that can accompany the treatment. In fact when I got home I went for a 20 mile bike ride.

FYI my ortho simply told me that PRP would be used, not the other way around. I believe they tend to do it during surgery because they make the stuff out of your own blood and you’re already hooked up. I really have no way of knowing if it’s effective or not. The theory sounds good though.

Bob P - Did you decide to undergo the PRP treatments on your own or was your surgeon on board with you doing it. I am going in on Wed to see the doc. I am betting he will either tell me it doesn’t help or flat out tell me not to do it cause it will jeopardize “his” repair.

I had PRP treatment after Achillies reconstructive surgery involving a tendon transfer. I had 3 treatments 6 weeks apart. I felt that it was beneficial. A day or so after each treatment I could feel an improvement in strength. It could be my imagination but it seemed to get the repaired area smoother, as in lining up the colligen in a more organized fashion mininizing the scar tissue.
After the first treatment I had the courage to ride hard on the bike standing on the pedals on the hills. IMHO it was the way to go.

It’s a promising new therapy, but not much tested yet. My ortho’s guess, when I asked him about it, was that it will be used most for annoying nonsurgical things like tennis elbow. It has been tried with nonsurgical Achilles treatment, and at the time of Achilles surgery, but I don’t know if it has been used after Achilles surgery has already been done. The rupture itself may cause enough inflammation that the PRP won’t have so much to add.

On a related note, I remember worrying that my tendon was so shredded at the time of my surgery, since that would make a messier (and presumably weaker, at least short term) repair. But maybe, in the long run, that’s a good thing, as all the inflammation (over more of the tendon) may do a better job of “treating” the underlying tendinosis that is often what led to the rupture in the first place. That could mean it’s stronger once it heals, in comparison to a “cleaner” rupture that might heal more quickly short term, but leave areas of tendinosis behind that might rupture later on. That’s only speculation.

Perhaps, if you have tendinosis in your other Achilles, (check with ultraso

Also, swelling in and around the injury site is much less now that I am walking. That might be attributable to the sock and boot acting to compress the foot or it could be because of the walking. Either way, I’ll take it.

Ray Fisher is truly old school. He pitched in the infamous 1919 World Series, near the end of his major league career. (For you young folks, that’s the series of the Black Sox scandal, the one that got Shoeless Joe Jackson barred from baseball for life, until his ghost showed up on a farm in Iowa.) Coach Fisher was a great guy and an incredible pitching coach, a real treasure.

My nephew played on that 1997 national championship football team. Interestingly, he’s now training to be an orthopedic surgeon.

And you had your surgery at CPMC. I did my last two years of medical training at the old Children’s Hospital of San Francisco, now part of CPMC.

Your story is inspiring. I think I might try to incorporate some of your regimen in with mine. On the doc he is my favorite buckeye right now but we’ll see how the recovery goes before I pass final judgment.

Wubfree,

That was my senior year of college and we just call it a national championship. No need for any of those qualifiers like “Co”.

Mike,

I like the sound of your story. Hopefully I can be looking at something similar when 10 weeks rolls around for me.

I ruptured mine playing basketball aswell, I’m a few years younger (25) but I was out of the cast in 4 weeks and attended a Met game at the new stadium at about 10 weeks. It was actually the last day I was in the boot, ditched it the next day but felt I needed the extra support for the walking at the stadium and through the subway. Depending on how the recovery is going you should be fine to attend the game. I remember when I got the second cast on at about 3 weeks I couldnt believe how small my leg got, but that was pretty much the low point for the atrophy.

Be careful disparaging basketball, Mike, that was one of my sports in Ann Arbor. (My coach was Bill Frieder, his first year there, my pitching coach was Ray Fisher, and Bo and Woody were going at it when I was there, so you know I go way back.)

Ten-plus weeks postop is exactly where I was when I wrote my long “how-to” note about a fairly fast recovery. I hope you can be ready for that game, even if you are saddled with a buckeye doctor. Does he hide his horns with a surgical cap?